Women with low-energy fracture should be investigated for osteoporosis

Abstract

Introduction Treatment of osteoporosis is becoming more effective, but methods to identify patients who are most suitable for investigation and treatment are still being debated. Should any type of fracture have higher priority for investigation of osteoporosis than any other? Is the number of previous fractures useful information?Material and methods We investigated 303 consecutive women patients between 55 and 75 years of age who had a newly diagnosed low-energy fracture. They answered a questionnaire on previous fractures which also dealt with risk factors. Bone mineral density (BMD) was measured at the hip, lumbar spine, and forearm.Results The distribution of fracture location was: distal forearm 56%, proximal humerus 12%, vertebra 18%, and hip 13%, all with similar age. Half of the subjects had had at least one previous fracture before the index fracture, 19% had had two previous fractures, and 6% had had three or more previous fractures. Patients with vertebral or hip fracture had lower BMD and had had more previous fractures than patients with forearm or humerus fractures. There was an inverse correlation between number of fractures and BMD. Osteoporosis was present in one-third of patients with forearm fracture, in one-half of those with hip or humerus fracture, and in two-thirds of those with vertebral fracture.Interpretation Vertebral fractures were the strongest marker of low BMD and forearm fractures the weakest. The number of previous fractures is helpful information for finding the most osteoporotic patient in terms of severity. Investigation of osteoporosis therefore seems

Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk

“…The total prevalence of low BMD (T-score ≤−2.0 SD) and osteoporosis (T-score ≤−2.5 SD) in our study is similar to findings in two previous studies on women [25,26]. Löfman et al [25] found T-scores <−2.0 SD in 53% and <−2.5 SD (osteoporosis) in 37% at total hip or spine in 171 Swedish women (mean age, 67 years) with distal radius fractures while McLellan et al [26] diagnosed osteoporosis at the same measurement sites in 41% of the 420 Glasgow women aged 50 years and older with similar fractures.…”

“…In previous studies, lower BMD in patients with a distal radius fracture compared with controls has been reported in both men [23] and women [14,24,25,37]. However, in two studies where heel BMD was used, no differences were found between patients with a distal radius fracture and controls [38,39].…”

“…In studies of small numbers of patients, BMD has been reported to be lower in distal radius fracture patients than in controls both in men [23] and women [13,24,25]. However, BMD has not been thoroughly investigated in large patient samples.…”

Low-energy distal radius fractures in middle-aged and elderly women—seasonal variations, prevalence of osteoporosis, and associates with fractures

“…A high percentage of women with low-energy distal radius fractures have osteoporosis [1] and bone mineral density (BMD) has been found to be lower in distal radius fractures patients compared to age-matched controls and bone density reference populations [2,3].…”

O Zoledronato no tratamento da osteoporose umeral em ratas: estudo prospectivo e randomizado

“…11 These also correspond to the fourth most frequent fracture during the osteoporosis period, responsible for 12% of all fractures. 12,13 According to Maravic et al 14 , in France, each humerus fracture of osteoporotic origin, generates individual annual costs around US$4,000. Zoledronate, which acts by inhibiting the osteoclastic action and, consequently, decreasing bone resorption, 15 can be used in the prophylaxis of fractures caused by osteoporosis.…”